The Patient Reported Outcomes Measurement Information System (PROMIS), an NIH Roadmap initiative, is a 5-year cooperative program of research designed to develop, evaluate, and standardize item banks to measure key health status domains relevant to a range of chronic medical conditions (e.g., cancer, depression, arthritis). The ultimate goal of this initiative is to produce clinical research tools, such as computerized-adaptive testing and non-adaptive assessments, and to make these tools broadly available for use in clinical research and clinical practice. The first phase of PROMIS has developed a total of 11 item banks across 6 domains and has made measurement of these domains accessible to researchers through an interactive website. One of the most significant areas identified but not yet developeed is the domain of cigarette smoking. The goal of this proposed project is to develop, evaluate, and standardize an item bank to assess cigarette smoking behavior and biopsychosocial constructs associated with smoking, and incorporate this item bank into the PROMIS framework. Smoking is relevant to nearly all health conditions and has a significant impact on morbidity and mortality. The addition of a smoking domain is a critical next step in the development of the PROMIS framework that would do much to expand its utility and applicability. The project has four specific aims: AIM 1: Identify smoking domain components and develop initial item pool; AIM 2: Evaluate measurement properties of item pool through analysis of survey response data; AIM 3: Provide descriptive information about the health status of smokers through analysis of smoking and other PROMIS domain score data; AIM 4: Examine the impact of smoking and the biopsychosocial constructs associated with smoking on health status and short term recovery among individuals seeking care at a general medical clinic. By the end of the project period, we will have developed, evaluated, and tested the initial validity for a psychometrically sound item bank that can form the basis for standardized assessment of smoking behavior and biopsychosocial constructs associated with smoking. The integration of this item bank into the existing PROMIS framework will do much to facilitate the study of associations between aspects of smoking and other health-related outcomes.